Cecco, C.N. (C.N.) de
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- Incidental dual source computed tomography imaging of ductal aortic coarctation, left subclavian artery stenosis and bicuspid aortic valve in a patient admitted for atypical chest pain(Oxford University Press, 2008) Herreros, J. (Jesús); Bastarrika, G. (Gorka); Cecco, C.N. (C.N.) de; Anselmi, A. (Amedeo)A case of incidental ductal aortic coarctation with left subclavian artery stenosis at the origin, severely calcified and stenotic bicuspid aortic valve, and normal coronary arteries demonstrated by single breath hold dual source computed tomography angiography in a 46-year-old man admitted for acute chest pain is presented.
- Valoración global del corazón en el paciente con transplante cardiaco mediante tomografía computarizada de doble fuente(Gobierno de Navarra. Departamento de Salud, 2009) Bastarrika, G. (Gorka); Cecco, C.N. (C.N.) de; Mastrobuoni, S. (Stefano); Rabago, G. (Gregorio); Arraiza, M. (María); Pueyo, J. (Jesús)In routine clinical practice surveillance of heart transplant recipients is usually performed using echocardiography and conventional coronary angiography. The latter permits diagnosis and follow-up of coronary allograft vasculopathy. However, this procedure is invasive and is not free of complications. Conventional multislice computed tomography (MSCT) has been shown to be a useful non-invasive tool for ruling out coronary artery disease and evaluating cardiac function. However, due to its limited temporal resolution betablocker administration is required, and its usefulness in certain patient populations with restricted response to this medication, such as heart transplant recipients, may therefore be limited. Dual-source CT (DSCT) allows evaluation of the coronary arteries in all individuals independent of their heart rate. In the case presented here, we demonstrate that DSCT may be useful for evaluating cardiac function and ruling out coronary allograft vasculopathy in heart transplant recipients.
- Dual-source CT for visualization of the coronary arteries in heart transplant patients with high heart rates(American Roentgen Ray Society, 2008) Bastarrika, G. (Gorka); Cecco, C.N. (C.N.) de; Ubilla, M. (Matias); Mastrobuoni, S. (Stefano); Rabago, G. (Gregorio); Arraiza, M. (María); Pueyo, J. (Jesús)OBJECTIVE. The purpose of this study was to evaluate the quality of dual-source CT images of the coronary arteries in heart transplant recipients with high heart rates. SUBJECTS AND METHODS. Contrast-enhanced dual-source CT coronary angiography was performed on 23 heart transplant recipients (20 men, three women; mean age, 61.1 ± 12.8 years). Data sets were reconstructed in 5% steps from 30% to 80% of the R-R interval. Two blinded independent readers using a 5-point scale (0, not evaluative; 4, excellent quality) assessed the quality of images of coronary segments. RESULTS. The mean heart rate during scanning was 89.2 ± 10.4 beats/min. Interobserver agreement on the quality of images of the whole coronary tree was a kappa value of 0.78 and for selection of the optimal reconstruction interval was a kappa value of 0.82. The optimal reconstruction interval was systole in 17 (74%) of the 23 of heart transplant recipients. At the best reconstruction interval, diagnostic image quality (score ≥ 2) was obtained in 92.1% (303 of 329) of the coronary artery segments. The mean image quality score for the whole coronary tree was 3.1 ± 1.01. No significant correlation between mean heart rate (ρ = 0.31) or heart rate variability (ρ = 0.23) and overall image quality score was observed (p = not significant). CONCLUSION. Dual-source CT acquisition yields coronary angiograms of diagnostic quality in heart transplant recipients. Mean heart rate and heart rate variability during scanning do not have a negative effect on the overall quality of images of the coronary arteries.
- Dual-source CT coronary imaging in heart transplant recipients: image quality and optimal reconstruction interval(Springer Nature, 2008) Bastarrika, G. (Gorka); Cecco, C.N. (C.N.) de; Arraiza, M. (María); Ubilla, M. (Matias); Mastrobuoni, S. (Stefano); Pueyo, J. (Jesús); Rabago, G. (Gregorio)The image quality and optimal reconstruction interval for coronary arteries in heart transplant recipients undergoing non-invasive dual-source computed tomography (DSCT) coronary angiography was evaluated. Twenty consecutive heart transplant recipients who underwent DSCT coronary angiography were included (19 male, one female; mean age 63.1 ± 10.7 years). Data sets were reconstructed in 5% steps from 30% to 80% of the R-R interval. Two blinded independent observers assessed the image quality of each coronary segments using a five-point scale (from 0 = not evaluative to 4 = excellent quality). A total of 289 coronary segments in 20 heart transplant recipients were evaluated. Mean heart rate during the scan was 89.1 ± 10.4 bpm. At the best reconstruction interval, diagnostic image quality (score ≥2) was obtained in 93.4% of the coronary segments (270/289) with a mean image quality score of 3.04 ± 0.63. Systolic reconstruction intervals provided better image quality scores than diastolic reconstruction intervals (overall mean quality scores obtained with the systolic and diastolic reconstructions 3.03 ± 1.06 and 2.73 ± 1.11, respectively; P < 0.001). Different systolic reconstruction intervals (35%, 40%, 45% of RR interval) did not yield to significant differences in image quality scores for the coronary segments (P = 0.74). Reconstructions obtained at the systolic phase of the cardiac cycle allowed excellent diagnostic image quality coronary angiograms in heart transplant recipients undergoing DSCT coronary angiography.
- Assessment of left ventricular parameters in orthotopic heart transplant recipients using dual-source CT and contrast-enhanced echocardiography: Comparison with MRI(Elsevier, 2012) Arraiza, M. (María); Azcarate, P.M. (Pedro María); Cecco, C.N. (C.N.) de; Viteri-Ramirez, G. (G.); Simon-Yarza, I. (Isabel); Hernandez-Estefania, R. (Rafael); Rabago, G. (Gregorio); Bastarrika, G. (Gorka)Objectives To establish the accuracy and reliability of cardiac dual-source CT (DSCT) and two-dimensional contrast-enhanced echocardiography (CE-Echo) in estimating left ventricular (LV) parameters with respect to cardiac magnetic resonance imaging (CMR) as the reference standard. Methods Twenty-five consecutive heart transplant recipients (20 male, mean age 62.7 ± 10.4 years, mean time since transplantation 8.1 ± 5.9 years) were prospectively recruited. Two blinded readers independently assessed LV ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), and stroke volume (SV) for each patient after manual tracing of the endo- and epicardial contours in DSCT, CE-Echo and CMR cine images. Student's t-test for paired samples for differences, and Bland and Altman plots and Lin's concordance-correlation coefficients (CCC) for agreement were calculated. Results There was no statistical difference between left ventricular parameters determined by DSCT and CMR. CE-Echo resulted in significant underestimation of left ventricular volumes (mean difference EDV: 15.94 ± 14.19 ml and 17.1 ± 17.06 ml, ESV: 8.5 ± 9.3 and 7.32 ± 9.14 ml with respect to DSCT and CMR), and overestimation of EF compared with the cross-sectional imaging modalities (3.78 ± 8.47% and 2.14 ± 8.35% with respect to DSCT and CMR). Concordance correlation coefficients for LV parameters using DSCT and CMR were higher (CCC ≥ 0.75) than CCC values observed between CE-Echo and DSCT- or CMR-derived data (CCC ≥ 0.54 and CCC ≥ 0.49, respectively). Interobserver agreement was higher for DSCT and CMR values (CCC ≥ 0.72 and CCC ≥ 0.87, respectively). Conclusion In orthotopic heart transplantation cardiac DSCT allows accurate and reliable estimation of LV parameters compared with CMR, whereas CE-Echo seems to be insufficient to obtain precise measurements.
- Quantification of left ventricular function and mass in heart transplant recipients using dual-source CT and MRI: initial clinical experience(Springer Nature, 2008) Bastarrika, G. (Gorka); Arraiza, M. (María); Cecco, C.N. (C.N.) de; Mastrobuoni, S. (Stefano); Ubilla, M. (Matias); Rabago, G. (Gregorio)The purpose of this study was to compare LV function and mass quantification derived from cardiac dual-source CT (DSCT) exams with those obtained by MRI in heart transplant recipients. Twelve heart transplant recipients who underwent cardiac DSCT and MRI examination were included. Double-oblique short-axis 8-mm slice thickness images were evaluated. Left ventricular ejection fraction, end-diastolic volume, end-systolic volume, stroke volume, cardiac output and myocardial mass were manually assessed for each patient by two blinded readers. A systematic overestimation of all left ventricular volumes by DSCT when compared with MRI was observed. Mean difference was 16.58 ± 18.61 ml for EDV, 4.9 4 ± 6.84 ml for ESV, 11.64 ± 13.58 ml for SV and 5.73 ± 1.14 l/min for CO. Slightly lower values for left ventricular ejection fraction with DSCT compared with MRI were observed (mean difference 0.34 ± 3.18%, p = 0.754). Correlation between DSCT and MRI for left ventricular mass was excellent (rho = 0.972). Bland and Altman plots and CCC indicated good agreement between DSCT and MRI left ventricular function and mass measurements. The interobserver correlation was good. In conclusion, DSCT accurately estimates left ventricular ejection fraction, volumes and mass in heart transplant recipients.
- Cardiovascular Dual Source Computed Tomography for Aortic Coarctation in a Neonate: One-Second Scan With Ultra-Low Radiation Dose(Elsevier, 2008) Bastarrika, G. (Gorka); Cecco, C.N. (C.N.) de; Bastero, P. (P.); Arraiza, M. (María); Barba, J. (Joaquín); Anselmi, A. (Amedeo); Alzina, V. (Valentín)